NPI | 1376195636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 13433) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DRPM2329) |
122300000X Dentist (Licence: AL D.0006684-c1) | |
Enumeration Date | 2019-07-16 |
Last Update Date | 2025-06-19 |