| NPI | 1831485010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 8549) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN014299) |
| Enumeration Date | 2011-06-25 |
| Last Update Date | 2019-12-06 |