NPI | 1407953359 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 6463) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 5901) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2007-07-08 |