| NPI | 1760521934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D11686) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 073) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2022-11-09 |