NPI | 1639747561 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SD D1401) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 7718) |
Enumeration Date | 2021-06-16 |
Last Update Date | 2023-07-12 |