NPI | 1881824217 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 32201) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS040043) |
122300000X Dentist (Licence: MI 2901020082) | |
1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS040043) | |
Enumeration Date | 2009-07-20 |
Last Update Date | 2018-03-17 |