| NPI | 1376247569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 7652) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 7652) |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2026-01-21 |