| NPI | 1053444547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012736) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN012736) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2018-12-19 |