| NPI | 1023692654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D012113) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 13020) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2024-08-12 |