NPI | 1396263398 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D10729) |
Additional Taxonomies | 122300000X Dentist (Licence: OR Na) |
1223G0001X Dentist, General Practice (Licence: OR D10729) | |
Enumeration Date | 2017-08-30 |
Last Update Date | 2021-06-08 |