NPI | 1063694719 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: GA DN013472) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 50 050784) |
Enumeration Date | 2007-12-04 |
Last Update Date | 2007-12-04 |