| NPI | 1023144136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PR 1427) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 16666) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2024-06-05 |