NPI | 1154515609 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401414226) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12011268A) |
1223G0001X Dentist, General Practice (Licence: IN 12011268A) | |
Enumeration Date | 2007-08-28 |
Last Update Date | 2019-12-20 |