NPI | 1003264821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC DEN1002122) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019.031604) |
Enumeration Date | 2016-06-02 |
Last Update Date | 2021-09-09 |