| NPI | 1053625715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 58075) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055114) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2011-06-16 |