| NPI | 1386255636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2024034359) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 12002) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2024-09-23 |