| NPI | 1710311972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV 6867) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 62848) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2018-07-02 |