NPI | 1598121402 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 17173) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN21573) |
1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN21573) | |
Enumeration Date | 2016-01-07 |
Last Update Date | 2020-03-06 |