| NPI | 1760978803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 103401) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 10867262-9922) |
| Enumeration Date | 2018-07-01 |
| Last Update Date | 2021-11-29 |