| NPI | 1245457183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN16945) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 16945) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN16945) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2018-07-23 |