| NPI | 1013297795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 64577) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 27271) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2015-11-23 |