| NPI | 1174259550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PR 3503) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 0911R) |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2025-05-24 |