| NPI | 1033371091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN015122) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8632) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 8632) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2016-04-22 |