| NPI | 1588051460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 9585) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 11347) |
| Enumeration Date | 2015-04-19 |
| Last Update Date | 2021-12-17 |