NPI | 1013032903 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: MD 09753) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MD 9753) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2019-03-04 |