| NPI | 1588861256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 6150-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 6150) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-01-20 |