| NPI | 1518057934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WI 1001197-15) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN012272) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: TX 24891) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2022-07-12 |