| NPI | 1487886594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 59266) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 50054621) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2010-11-16 |