| NPI | 1790975597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57764) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DR20000194) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2015-09-14 |