NPI | 1003957648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.022271) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 5084) |
1223G0001X Dentist, General Practice (Licence: CA 55341) | |
Enumeration Date | 2007-02-08 |
Last Update Date | 2011-12-01 |