| NPI | 1528378700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 12258) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 60735298) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2021-07-12 |