| NPI | 1790949550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 820) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 4498) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2024-10-04 |