| NPI | 1326526211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 1178) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 10659) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2023-07-09 |