| NPI | 1396263398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D10729) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR Na) |
| 1223G0001X Dentist, General Practice (Licence: OR D10729) | |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2021-06-08 |