| NPI | 1336767029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN27688) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS042800) |
| 122300000X Dentist (Licence: VA 0442000420) | |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2023-07-19 |