NPI | 1225351810 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57423) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 25230) |
Enumeration Date | 2010-03-10 |
Last Update Date | 2019-10-11 |