| NPI | 1831753177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 106959) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D11121) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NM DB-2023-0058) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D11121) | |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2023-05-30 |