| NPI | 1598157141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 126) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 058706-1) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2026-01-25 |