NPI | 1124275326 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D009485) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 5918) |
Enumeration Date | 2008-08-19 |
Last Update Date | 2024-11-10 |