| NPI | 1235495664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 842) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 8156) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2022-08-25 |