NPI | 1154808988 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MD 16552) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416158) |
Enumeration Date | 2018-07-24 |
Last Update Date | 2018-10-22 |