| 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 |