| NPI | 1942598040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: ID D-4371-PD) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223G0001X Dentist General Practice (Licence: ID D4371) | |
| 122300000X Dentist (Licence: ID D4371) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2023-07-21 |