| NPI | 1629134317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WV 3557) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401410708) |
| 122300000X Dentist (Licence: WV 3557) | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: WV 3557) | |
| 207L00000X Anesthesiology (Licence: VA 0401410708) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2022-03-11 |