| NPI | 1124275326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D009485) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 5918) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2017-03-17 |