| NPI | 1083837660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 583PD) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 3818) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2026-01-10 |