| NPI | 1578787842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 58339) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA S 457) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 23523) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2012-11-15 |