NPI | 1154555894 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 60162) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055141) |
1223P0221X Dentist, Pediatric Dentistry (Licence: CT 010192) | |
Enumeration Date | 2009-05-10 |
Last Update Date | 2018-07-26 |