NPI | 1003591843 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 18731) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN28018) |
Enumeration Date | 2023-06-20 |
Last Update Date | 2025-06-11 |