| NPI | 1154445435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN013867) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 22646) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: TX 22646) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2014-01-10 |