NPI | 1083790356 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 3199) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 11172) |
Enumeration Date | 2006-10-30 |
Last Update Date | 2023-08-08 |