NPI | 1184989782 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MA DN1858554) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 28151) |
Enumeration Date | 2012-07-10 |
Last Update Date | 2020-01-09 |