NPI | 1023634433 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D14636) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA DDS-09788) |
Enumeration Date | 2020-06-22 |
Last Update Date | 2021-07-27 |