NPI | 1003530163 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401418768) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901601551) |
Enumeration Date | 2022-10-03 |
Last Update Date | 2024-07-08 |