| NPI | 1508134040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 10611) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: HI 2355) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 60388) | |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |