| NPI | 1881859148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1000721) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14020) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2018-07-22 |