NPI | 1518370360 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN20624) |
Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: MD LL705) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2020-07-20 |