| NPI | 1649689704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE.61294850) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS040063) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NM DD5471) | |
| Enumeration Date | 2014-08-03 |
| Last Update Date | 2022-11-10 |