NPI | 1144501677 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1001051) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15039) |
1223G0001X Dentist, General Practice (Licence: VA 0401413266) | |
Enumeration Date | 2011-08-29 |
Last Update Date | 2017-12-28 |