| NPI | 1326308990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 9049) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9049) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 953) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2015-07-17 |