| NPI | 1497068118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MS 3543-10) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3543-10) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2012-07-24 |