| NPI | 1902152713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE61645658) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: HI DT 2478) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2025-03-11 |