| NPI | 1649583428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR d9707) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 6534-015) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2014-09-30 |