NPI | 1376648493 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00009883) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA 07587) |
Enumeration Date | 2006-09-13 |
Last Update Date | 2013-03-19 |