| NPI | 1740841576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA DDS-09693) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 2048) |
| 1223G0001X Dentist, General Practice (Licence: IA DDS-09693) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2025-01-05 |