| NPI | 1952754970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 10466) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 9119) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2023-03-03 |