| NPI | 1679954788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 10850) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22180) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN22180) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2023-09-11 |