| NPI | 1699828681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 3125) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401008654) |
| 122300000X Dentist (Licence: GA 012326) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 0476 PD) | |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2010-03-03 |