| NPI | 1285909010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 791 PD) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC DGD.7093 GD) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2013-07-17 |