| NPI | 1700857307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 02493) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 306) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2012-12-03 |