NPI | 1396122248 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 16468) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 0585841) |
Enumeration Date | 2015-04-29 |
Last Update Date | 2023-03-06 |