NPI | 1043306814 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 14838) |
Additional Taxonomies | 122300000X Dentist (Licence: DC DEN5121) |
1223G0001X Dentist, General Practice (Licence: DC DEN5121) | |
122300000X Dentist (Licence: VA 0401417896) | |
1223G0001X Dentist, General Practice (Licence: VA 0401417896) | |
Enumeration Date | 2006-10-05 |
Last Update Date | 2022-06-28 |