| NPI | 1740325232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 8474) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8474) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2014-11-30 |