NPI | 1528446606 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA DDS-09967) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.030462) |
Enumeration Date | 2015-05-11 |
Last Update Date | 2022-04-28 |