| NPI | 1215290390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NM DD5246) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI 2646) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: HI DT-2646) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NM DD4404) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: HI 2646) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2023-07-24 |