| NPI | 1760026579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 107478) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 35789) |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2025-05-22 |