| NPI | 1366174385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401418812) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 7317) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2025-09-26 |