| NPI | 1972734705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401413587) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413587) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2019-09-04 |