| NPI | 1376792861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: HI DT2341) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 6775) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2010-06-21 |