| NPI | 1780899260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 40848) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2015-06-05 |