NPI | 1891156238 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN23699) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 060001) |
Enumeration Date | 2016-03-13 |
Last Update Date | 2021-01-14 |