NPI | 1164686770 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS045144) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 22231) |
1223G0001X Dentist, General Practice (Licence: FL DN23308) | |
Enumeration Date | 2008-07-12 |
Last Update Date | 2025-06-18 |