NPI | 1194864884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D011584) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV 2986) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2022-10-03 |