NPI | 1073708418 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NC 10193) |
Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: NC 10193) |
1223P0221X Dentist Pediatric Dentistry (Licence: NC 10193) | |
Enumeration Date | 2007-09-10 |
Last Update Date | 2017-01-27 |