NPI | 1083392773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ID D-5543) |
Additional Taxonomies | 122300000X Dentist (Licence: ID D-5543) |
Enumeration Date | 2023-07-11 |
Last Update Date | 2024-06-25 |