NPI | 1730531427 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DRP1612) |
Additional Taxonomies | 122300000X Dentist (Licence: MS 3867-16) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2016-07-06 |