| NPI | 1518275783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 9530) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 22810) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2012-07-18 |