NPI | 1154843563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OH 30025572) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS041388) |
Enumeration Date | 2017-07-07 |
Last Update Date | 2020-02-12 |