| NPI | 1154684058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 111477) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 27923) |
| Enumeration Date | 2012-06-17 |
| Last Update Date | 2025-09-29 |