NPI | 1114313566 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 105831) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 057374) |
Enumeration Date | 2015-04-13 |
Last Update Date | 2022-07-13 |