| NPI | 1346449758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN014190) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30-023272) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2013-01-16 |