NPI | 1134319213 |
---|---|
Former Name | SOPHIE ADEBISSI LIAMIDI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 8028) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 23500) |
Enumeration Date | 2007-07-26 |
Last Update Date | 2024-09-20 |