| NPI | 1851447502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 48307) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2018043094) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: KS 60035) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2019-01-03 |