NPI | 1154300879 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NE 6463) |
Additional Taxonomies | 122300000X Dentist (Licence: NC 8706) |
1223G0001X Dentist, General Practice (Licence: NC 8706) | |
Enumeration Date | 2006-01-11 |
Last Update Date | 2020-10-27 |