| NPI | 1841430642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 9793) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN014864) |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2014-09-09 |