NPI | 1629483425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 1009) |
Additional Taxonomies | 122300000X Dentist (Licence: SC 9404) |
122300000X Dentist (Licence: NC 9806) | |
Enumeration Date | 2014-07-01 |
Last Update Date | 2023-11-07 |