| NPI | 1902906993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 8860) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 108106) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-08 |