| NPI | 1184794562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MD 13171) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: DC DEN1000383) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0401411614) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-06-30 |