| NPI | 1346817541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE61565578) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 1346817541) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI03004600) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-12-13 |