| NPI | 1730531427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DRP1612) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3867-16) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |