| NPI | 1437496239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WA DE60903814) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0401414922) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2022-07-14 |