| NPI | 1972943843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D011017) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D13432) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2025-01-29 |