| NPI | 1093197378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-167) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI DTT260) |
| 122300000X Dentist (Licence: CA 64856) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D10931) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2019-05-02 |