| NPI | 1235113283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 61151) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 8177) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 24782) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 54316-1) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2014-04-23 |