| NPI | 1194810143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ME DEN4211) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30022274) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6111) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-02-06 |