NPI | 1861928426 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 101195) |
Additional Taxonomies | 122300000X Dentist (Licence: CA dds101195) |
Enumeration Date | 2017-05-02 |
Last Update Date | 2023-03-26 |