| NPI | 1639747561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: SD D1401) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NE 7718) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2023-07-12 |