| NPI | 1164743480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN DS9375) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN19031) |
| 1223G0001X Dentist, General Practice (Licence: TN DS00000093751) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2021-01-19 |