| NPI | 1487392163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN123390) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN2000339) |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2024-05-05 |