| NPI | 1851744783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6664) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 6664) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2018-09-13 |