| NPI | 1699845453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC DEN3930) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 08010) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2007-07-08 |