NPI | 1235548066 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D10565) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057391) |
Enumeration Date | 2014-08-06 |
Last Update Date | 2016-12-26 |