NPI | 1043736473 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA DDS-09844) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.031326) |
Enumeration Date | 2017-08-17 |
Last Update Date | 2021-01-20 |