| NPI | 1720584410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 1112) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10506) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2020-09-15 |