NPI | 1336329937 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00011206) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24487) |
122300000X Dentist (Licence: CT 009659) | |
Enumeration Date | 2007-11-12 |
Last Update Date | 2025-09-29 |