NPI | 1427054717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 10052) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 047169-1) |
122300000X Dentist (Licence: SC 10043) | |
Enumeration Date | 2005-06-22 |
Last Update Date | 2024-09-12 |