| NPI | 1083054795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 8525) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6058) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2019-04-10 |