| NPI | 1942748140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MD 16215) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16215) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2024-10-01 |