| NPI | 1205036464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14059) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN1000627) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2011-08-02 |