NPI | 1114105293 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 007906) |
Additional Taxonomies | 122300000X Dentist (Licence: CT 007906) |
Enumeration Date | 2008-01-31 |
Last Update Date | 2013-03-13 |