NPI | 1407416811 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN24216) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN24216) |
Enumeration Date | 2019-06-18 |
Last Update Date | 2021-06-08 |