| NPI | 1528475894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-175) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 6529) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2022-02-21 |