| NPI | 1083028773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 105105) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15475) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 33484) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2022-04-14 |