| NPI | 1356302046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 4592) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 4592) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2015-01-20 |