NPI | 1548221401 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D009438) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NM DD2413) |
Enumeration Date | 2006-03-30 |
Last Update Date | 2017-04-27 |