NPI | 1568190106 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN27331) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN27331) |
Enumeration Date | 2022-08-11 |
Last Update Date | 2024-08-01 |