| NPI | 1417517129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OR D11448) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: IA DDS-09680) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2022-08-05 |