NPI | 1184803751 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00010814) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D9549) |
Enumeration Date | 2007-10-30 |
Last Update Date | 2011-08-01 |