| NPI | 1700077344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 9507) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN S43) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2019-11-04 |