| NPI | 1114145471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TN TN5017) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 972) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: AK 113) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2013-02-21 |