NPI | 1639269053 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 5248) |
Additional Taxonomies | 122300000X Dentist (Licence: OK 5248) |
122300000X Dentist (Licence: CO 7780) | |
Enumeration Date | 2006-10-14 |
Last Update Date | 2013-09-27 |