NPI | 1497091367 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-168) |
Additional Taxonomies | 122300000X Dentist (Licence: NV 6328) |
Enumeration Date | 2012-12-21 |
Last Update Date | 2019-06-17 |