NPI | 1164160537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401419243) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859406) |
1223G0001X Dentist, General Practice (Licence: AZ D012016) | |
Enumeration Date | 2022-05-25 |
Last Update Date | 2024-11-29 |