| NPI | 1689015398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D008783) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D008783) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DR60463744) | |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2016-06-27 |