| NPI | 1598406373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2024000089) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2024000089) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-02-23 |