NPI | 1497195499 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN 21002) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DL11955) |
Enumeration Date | 2013-07-05 |
Last Update Date | 2021-02-16 |