NPI | 1306165311 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401413765) |
Additional Taxonomies | 284300000X Special Hospital (Licence: MD 0401413765) |
Enumeration Date | 2010-06-01 |
Last Update Date | 2013-07-11 |