NPI | 1346552569 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AK 104910) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 8978) |
122300000X Dentist (Licence: NC 8978) | |
Enumeration Date | 2010-07-02 |
Last Update Date | 2015-12-28 |