| NPI | 1487391397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 12706) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 10272) |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2022-06-29 |