| NPI | 1023216546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 13664) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 5857) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2012-07-10 |