| NPI | 1720734379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 143) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 7557) |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2024-07-12 |