| NPI | 1881269777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 10590) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 10590) |
| 1223G0001X Dentist, General Practice (Licence: KY 10590) | |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2023-07-05 |