NPI | 1427461383 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401415108) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901600553) |
1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1858069) | |
Enumeration Date | 2014-06-09 |
Last Update Date | 2024-08-07 |