| NPI | 1700268141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN015284) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 9575) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2024-10-03 |