| NPI | 1649432584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D9995) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 10046) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2015-09-28 |