NPI | 1194101725 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60574353) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE60574353) |
Enumeration Date | 2015-08-05 |
Last Update Date | 2017-03-11 |