NPI | 1063534857 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 8176) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 130) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2022-02-14 |