NPI | 1033773429 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MD 17311) |
Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1002211) |
Enumeration Date | 2019-05-01 |
Last Update Date | 2021-08-05 |