NPI | 1942582937 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 61393) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 50055761) |
Enumeration Date | 2011-09-15 |
Last Update Date | 2012-07-30 |