| NPI | 1619290905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 62096) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY #390200000x) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02439000) | |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2016-08-03 |