| NPI | 1336410182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DNO14492) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 5886) |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2014-04-09 |