| NPI | 1689938920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN20020) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 20020) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2023-05-20 |