| NPI | 1043379951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: DC 5407) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC 5407) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2021-01-08 |