| NPI | 1942250014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 3364-461) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 11318) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2008-05-27 |