NPI | 1003550088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN2000178) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401418160) |
1223G0001X Dentist, General Practice (Licence: MD 17740) | |
Enumeration Date | 2022-04-25 |
Last Update Date | 2022-10-14 |