| NPI | 1881979425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA DDS106219) |
| Additional Taxonomies | 122300000X Dentist (Licence: VT 016.0079963) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2023-04-24 |