| NPI | 1902034382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 140) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901020044) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MN S141) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2023-04-19 |