| NPI | 1780141580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 10311) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WV 4541) |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2021-07-15 |