| NPI | 1225312275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19439) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19439) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2020-05-31 |