| NPI | 1609337930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 12578) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 00187) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-06-04 |