| NPI | 1407222300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN25766) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1857032) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2021-08-09 |