NPI | 1003390527 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MI 2901022725) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN24849) |
Enumeration Date | 2018-09-20 |
Last Update Date | 2020-10-29 |