NPI | 1073174025 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: SC 9366) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 2017) |
Enumeration Date | 2019-06-20 |
Last Update Date | 2021-07-27 |