| NPI | 1336104827 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0184) | 
| Additional Taxonomies | 122300000X Dentist (Licence: VA VA0184) | 
| Enumeration Date | 2006-04-19 | 
| Last Update Date | 2025-09-11 |