| NPI | 1487847703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 5610) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D-3495) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |