NPI | 1174932511 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NV S6-182C) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 42679) |
122300000X Dentist (Licence: TX 33661) | |
1223P0221X Dentist Pediatric Dentistry (Licence: CA 42679) | |
Enumeration Date | 2014-08-11 |
Last Update Date | 2020-07-31 |