| NPI | 1689177834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: PR 3366) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PR 3366) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2024-05-21 |