| NPI | 1386922474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ME RES90) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 9295) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 9295) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2023-10-23 |