| NPI | 1881824217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 32201) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS040043) |
| 122300000X Dentist (Licence: MI 2901020082) | |
| 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS040043) | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2018-03-17 |