| NPI | 1902287915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401416169) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DF11038) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-04-24 |