| NPI | 1194749978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 4123) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 9012) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 4123) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2012-07-10 |