| NPI | 1639493810 |
|---|---|
| Other Name | NONE NONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD LL739) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE 60329533) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2022-07-22 |