| NPI | 1255993051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 7573) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 7573) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2021-09-02 |