| NPI | 1386890390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 56935) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 50 054005) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: TX 25252) | |
| Enumeration Date | 2008-08-09 |
| Last Update Date | 2013-07-11 |