NPI | 1194354480 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901601351) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12013377A) |
Enumeration Date | 2020-04-07 |
Last Update Date | 2022-09-12 |