NPI | 1083001598 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 8243) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 882) |
Enumeration Date | 2015-04-22 |
Last Update Date | 2023-06-13 |