NPI | 1962935221 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: SC DGD.10410) |
Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0401416739) |
1223P0221X Dentist Pediatric Dentistry (Licence: NC 12957) | |
1223P0221X Dentist Pediatric Dentistry (Licence: MD 16704) | |
Enumeration Date | 2017-04-04 |
Last Update Date | 2023-03-02 |