| NPI | 1427587682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OK 113) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 6929) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2019-08-12 |