NPI | 1184062226 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MO 2020011221) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE60457750) |
Enumeration Date | 2013-06-11 |
Last Update Date | 2020-08-03 |