| NPI | 1467022699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MO 2023006785) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NE 7740) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2024-05-21 |