| NPI | 1376648493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00009883) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA 07587) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2013-03-19 |