| NPI | 1730316597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CT 011108) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: GA DN013919) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: LA 6938) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2018-12-04 |