NPI | 1316310303 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN 20703) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN20703) |
Enumeration Date | 2015-11-12 |
Last Update Date | 2022-09-22 |