| NPI | 1790843381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 41055) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 41055) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 41055) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2021-07-23 |