NPI | 1013466630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: AZ D011705) |
Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CA 100831) |
Enumeration Date | 2016-09-23 |
Last Update Date | 2023-06-13 |