NPI | 1548790405 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN22563) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 9972) |
Enumeration Date | 2017-06-14 |
Last Update Date | 2019-09-04 |