| NPI | 1437321742 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013695)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: DC DEN1000575)  | 
| 1223G0001X Dentist, General Practice (Licence: VA 0401411580)  | |
| 1223G0001X Dentist, General Practice (Licence: MD 13970)  | |
| Enumeration Date | 2008-03-26 | 
| Last Update Date | 2015-03-26 |