| NPI | 1285704122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8228) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC DEN1000885) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2012-08-09 |