| NPI | 1245528686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN19467) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 30734) |
| 1223P0300X Dentist Periodontics (Licence: FL DN19467) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2022-02-09 |