NPI | 1053577288 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24688) |
Additional Taxonomies | 122300000X Dentist (Licence: KS 60584) |
Enumeration Date | 2008-08-07 |
Last Update Date | 2018-02-12 |