NPI | 1972035939 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 16913) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD LL837) |
Enumeration Date | 2017-03-29 |
Last Update Date | 2021-02-26 |