NPI | 1497319990 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 27691) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2951000841) |
Enumeration Date | 2019-04-30 |
Last Update Date | 2023-04-05 |