| NPI | 1659738367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 107451) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025523) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: KS 61137) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2016014866) | |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2022-07-12 |