NPI | 1629276498 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401410098) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 051253-1) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2009-05-07 |