| NPI | 1770622821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57786) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 9145) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: HI 2034) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 051702-01) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-10-13 |