| NPI | 1669517629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-98) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 5068) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2010-02-15 |