| NPI | 1508498999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 1149) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042537) |
| 122300000X Dentist (Licence: KY 10409) | |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2022-07-06 |