NPI | 1821400300 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 25425) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 058973) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-06-02 |
Last Update Date | 2025-08-15 |