| NPI | 1700319035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 10915) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA ds043566) |
| 1223D0001X Dentist, Dental Public Health (Licence: NC 10915) | |
| 1223G0001X Dentist, General Practice (Licence: NC 10915) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-06-26 |