| NPI | 1639269053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 5248) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 5248) |
| 122300000X Dentist (Licence: CO 7780) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2013-09-27 |