| NPI | 1174932511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-182C) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 42679) |
| 122300000X Dentist (Licence: TX 33661) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 42679) | |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2020-07-31 |