| NPI | 1619358637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2014023988) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KS 61700) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2025-12-03 |