| NPI | 1790002038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19570) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 14717) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2012-02-02 |