| NPI | 1083346431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN30739) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901601328) |
| Enumeration Date | 2022-06-25 |
| Last Update Date | 2025-09-11 |