NPI | 1740663715 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6569) |
Additional Taxonomies | 122300000X Dentist (Licence: LA 6569) |
Enumeration Date | 2015-07-08 |
Last Update Date | 2025-07-21 |