| NPI | 1336104827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 122300000X Dentist (Licence: VA VA0184) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0184) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |