| NPI | 1376708180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401411508) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 13982) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2011-02-08 |