| NPI | 1861853798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0445000304) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416023) |
| Enumeration Date | 2016-03-20 |
| Last Update Date | 2018-07-21 |