| NPI | 1932335320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 59271) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 054107-1) |
| Enumeration Date | 2009-05-31 |
| Last Update Date | 2024-07-12 |