NPI | 1134357676 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE 60355119) |
Additional Taxonomies | 122300000X Dentist (Licence: MN D12652) |
Enumeration Date | 2009-06-23 |
Last Update Date | 2013-08-13 |