| NPI | 1174182463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 260204) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN24159) |
| 1223G0001X Dentist, General Practice (Licence: NC 260204) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2024-08-07 |