| NPI | 1730316597 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 11247)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN013919)  | 
| 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6938)  | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 011108)  | |
| Enumeration Date | 2009-06-18 | 
| Last Update Date | 2024-12-19 |