| NPI | 1811042302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: HI DT 2289) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 6561) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2010-09-27 |