| NPI | 1922386473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 61725) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901021180) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2021-12-30 |