| NPI | 1205373644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 101920) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 059172) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2022-06-13 |