| NPI | 1689170292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PR 3257) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 3257) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2019-08-02 |