NPI | 1437321742 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN013695) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: DC DEN1000575) |
1223G0001X Dentist General Practice (Licence: VA 0401411580) | |
1223G0001X Dentist General Practice (Licence: MD 13970) | |
Enumeration Date | 2008-03-26 |
Last Update Date | 2015-03-26 |