| NPI | 1780950287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401413945) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413945) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22D102530000) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 34799) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2022-09-17 |