| NPI | 1568954089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC DGD9682DS) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 9595) |
| 122300000X Dentist (Licence: KY 10110) | |
| 122300000X Dentist (Licence: NC 11677) | |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2024-06-27 |