| NPI | 1497489744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 17330) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC DEN2000111) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |