NPI | 1386010866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: WA 60684370) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 31390) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2016-11-09 |