| NPI | 1205028396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 11291) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57086) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 8390) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2022-09-21 |