NPI | 1467787713 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 64349) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.028586) |
1223G0001X Dentist, General Practice (Licence: MD 14602) | |
Enumeration Date | 2009-10-05 |
Last Update Date | 2020-05-19 |