NPI | 1215244249 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 58726) |
Additional Taxonomies | 251K00000X Public Health or Welfare |
1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19080) | |
1223P0221X Dentist, Pediatric Dentistry (Licence: TX 27825) | |
Enumeration Date | 2010-09-13 |
Last Update Date | 2017-05-03 |