NPI | 1710007984 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DE G1-0011477) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55197) |
Enumeration Date | 2007-03-30 |
Last Update Date | 2023-08-16 |