| NPI | 1871756304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 8958) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 51671) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2016-02-25 |