| NPI | 1144588997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN014698) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 9192) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2014-05-08 |