| NPI | 1093154460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PR 3211) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 3211) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN23920) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2023-09-22 |