| NPI | 1568545671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: KY KY 6755 KYSL 674) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY KY 6755 KYSL 674) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2015-01-20 |