| NPI | 1114164878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD LL831) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401412351) |
| 1223G0001X Dentist, General Practice (Licence: SC 7077) | |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2020-04-29 |