| NPI | 1376737866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 5908) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 5908) |
| 122300000X Dentist (Licence: MO 2007014391) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2017-02-17 |