| NPI | 1467948547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2022005260) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 7103) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 10553) | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2022-08-22 |