| NPI | 1164588778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE8593) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D7675) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-07-08 |