| NPI | 1174143903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 12048) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN122913) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2023-01-31 |