NPI | 1386756054 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 13688) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WV 3616) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2024-07-18 |