| NPI | 1538453436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MD 15285) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0401413950) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2022-11-16 |