| NPI | 1750636569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 9567) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 19624) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2024-05-30 |