NPI | 1417018953 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 17031) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS035699) |
Enumeration Date | 2006-12-12 |
Last Update Date | 2010-08-20 |