| NPI | 1386756054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 13688) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WV 3616) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-05-08 |