| NPI | 1578878435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D11308) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 27635) |
| 1223G0001X Dentist, General Practice (Licence: GA DN014164) | |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2020-08-27 |