| NPI | 1952963746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MD 11650) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0401416201) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2019-07-02 |