NPI | 1124260104 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401416294) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN0014852) |
Enumeration Date | 2009-04-06 |
Last Update Date | 2021-09-30 |