| NPI | 1528474822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0442000447) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN20612) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2022-08-09 |