| NPI | 1053547703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 19957) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 19957) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2012-11-05 |