NPI | 1649387127 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN010318) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: GA DN010318) |
Enumeration Date | 2006-08-23 |
Last Update Date | 2018-04-19 |