NPI | 1336498625 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN24006) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN24006) |
Enumeration Date | 2012-09-03 |
Last Update Date | 2019-07-11 |