NPI | 1700266236 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 10082) |
Additional Taxonomies | 122300000X Dentist (Licence: NC 10082) |
Enumeration Date | 2015-05-29 |
Last Update Date | 2018-11-26 |