| NPI | 1659630432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN26481) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: VT 0160119727) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2023-06-24 |