| NPI | 1326584335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NV S6-170) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 7026) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2018-10-29 |