| NPI | 1982742391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN012745) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 12635) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2014-08-22 |