NPI | 1902157100 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 39762) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS039360) |
Enumeration Date | 2012-09-27 |
Last Update Date | 2023-07-13 |