| NPI | 1356722219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D10256) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10256) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2019-12-31 |