NPI | 1538454517 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901020874) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901020874) |
1223G0001X Dentist, General Practice (Licence: IL 019.028593) | |
1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.002426) | |
Enumeration Date | 2011-06-17 |
Last Update Date | 2024-08-26 |