NPI | 1225191927 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 16260) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 7472) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2020-01-05 |