NPI | 1598252447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 12616) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS042539) | |
Enumeration Date | 2018-04-17 |
Last Update Date | 2022-07-25 |