NPI | 1184191132 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MD 104) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901021766) |
Enumeration Date | 2018-10-29 |
Last Update Date | 2024-09-05 |