| NPI | 1235562901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401413968) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 9486) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2023-02-10 |