| NPI | 1902199417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2011015039) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2011015039) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2024-12-17 |