| NPI | 1316140437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 8024) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8024) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2014-04-09 |