NPI | 1356302608 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57203) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D5255) |
1223G0001X Dentist, General Practice (Licence: OR 7277) | |
Enumeration Date | 2006-03-28 |
Last Update Date | 2017-10-05 |