NPI | 1104918945 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 8238) |
Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: KY 8238) |
1223G0001X Dentist, General Practice (Licence: KY 8238) | |
Enumeration Date | 2006-09-29 |
Last Update Date | 2024-09-18 |