| NPI | 1407953359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 6463) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 5901) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-08 |