| NPI | 1306165311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401413765) |
| Additional Taxonomies | 284300000X Special Hospital (Licence: MD 0401413765) |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2013-07-11 |