| NPI | 1780098129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2014017372) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61506) |
| 122300000X Dentist (Licence: MO 2014017372) | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2019-07-30 |