| NPI | 1396064333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 60684878) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY P70046) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2025-06-23 |