| NPI | 1871751339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OR D9692) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MN D12510) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2020-05-21 |