NPI | 1639538168 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MD 16273) |
Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: MD LL792) |
Enumeration Date | 2016-02-11 |
Last Update Date | 2017-10-31 |