NPI | 1154843688 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN22859) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN22859) |
Enumeration Date | 2017-07-17 |
Last Update Date | 2023-04-18 |