| NPI | 1194208280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN28670) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 6926) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: LA 6926) | |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2023-11-09 |