NPI | 1598085078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 60381) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1855382) |
Enumeration Date | 2010-06-07 |
Last Update Date | 2011-06-10 |