| NPI | 1023239456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 53480) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22285) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2008-11-25 |