NPI | 1992907471 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 15333) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901020620) |
1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS036963) | |
Enumeration Date | 2007-06-05 |
Last Update Date | 2014-03-07 |