| NPI | 1023310810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 9047) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NC 9047) |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2022-04-25 |