NPI | 1801458484 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN24353) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL D24353) |
Enumeration Date | 2019-07-03 |
Last Update Date | 2021-06-29 |