| NPI | 1033522578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA DDS100902) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02656600) |
| 122300000X Dentist (Licence: CA DDS100902) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2018-06-21 |