| NPI | 1558510412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 12182) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60035929) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 34845) | |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2025-06-06 |