NPI | 1619263084 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401414379) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN014259) |
Enumeration Date | 2011-06-23 |
Last Update Date | 2015-10-20 |