| NPI | 1346608478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: FL 20633) |
| Additional Taxonomies | 282NC2000X General Acute Care Hospital Children (Licence: FL 20633) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2016-07-19 |