| NPI | 1649615030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 64942) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 057199-1) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2022-07-21 |