| NPI | 1215244249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 58726) |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN19080) | |
| 1223P0221X Dentist Pediatric Dentistry (Licence: TX 27825) | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2017-05-03 |