| NPI | 1942651690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 108869) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 35846) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2023-06-30 |