| NPI | 1013279769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 21700) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2024-04-23 |