| NPI | 1871850131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 00202738) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WY 1572) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057812) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-05-17 |