| NPI | 1104951813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401411957) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 12942) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2012-04-05 |