| NPI | 1639278484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC 5260) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 10371) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-12-18 |