| NPI | 1497918684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 6237) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013729) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2013-01-02 |