NPI | 1144671694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MO 2016021150) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 61510) |
Enumeration Date | 2016-06-27 |
Last Update Date | 2019-02-27 |