| NPI | 1669639191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 8285) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 8285) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2013-05-07 |