NPI | 1245528686 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19467) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 30734) |
1223P0300X Dentist, Periodontics (Licence: FL DN19467) | |
Enumeration Date | 2011-07-19 |
Last Update Date | 2022-02-09 |