| NPI | 1306135538 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 100479) | 
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019028998) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D009173) | |
| Enumeration Date | 2011-03-28 | 
| Last Update Date | 2016-08-15 |