NPI | 1134570344 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901021931) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021931) |
Enumeration Date | 2016-06-29 |
Last Update Date | 2019-11-13 |