| NPI | 1689988651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OR D9438) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D9438) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2013-03-04 |