| NPI | 1881657310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 53157) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 53157) |
| 122300000X Dentist (Licence: MD 12742) | |
| 1223P0221X Dentist Pediatric Dentistry (Licence: MD 12742) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2010-06-25 |