| NPI | 1184287872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 1002582-15) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D14521) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2021-07-09 |