| NPI | 1942552500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA 1942552500) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9408) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2021-07-23 |