NPI | 1720215726 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.024899) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22D102410200) |
1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS038483) | |
Enumeration Date | 2009-06-17 |
Last Update Date | 2016-09-16 |