| NPI | 1386923399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60500193) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 056735) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2024-08-30 |