| NPI | 1942582937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 61393) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 50055761) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2012-07-30 |