| NPI | 1568191955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN28954) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 10801) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2024-10-28 |