| NPI | 1700190790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-186) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 6561) |
| 1223G0001X Dentist, General Practice (Licence: TX 25566) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2023-05-29 |