| NPI | 1386749042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 8129) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 8129) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2008-04-08 |