NPI | 1801299177 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN21385) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DL12313) |
Enumeration Date | 2014-10-01 |
Last Update Date | 2023-06-27 |