| NPI | 1467890541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60935386) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: VT 016.0131058) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2019-05-24 |