| NPI | 1609363795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 6001148-15) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 10140) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2023-06-13 |