| NPI | 1861656738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60404303) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 10081098) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D9593) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2013-12-30 |