NPI | 1558872978 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 60662094) |
Additional Taxonomies | 122300000X Dentist (Licence: WA 60662094) |
Enumeration Date | 2017-10-12 |
Last Update Date | 2018-06-27 |