NPI | 1093197378 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-167) |
Additional Taxonomies | 122300000X Dentist (Licence: HI DTT260) |
122300000X Dentist (Licence: CA 64856) | |
1223P0221X Dentist, Pediatric Dentistry (Licence: OR D10931) | |
Enumeration Date | 2015-06-23 |
Last Update Date | 2019-05-02 |