NPI | 1205190477 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122225) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413434) |
1223G0001X Dentist, General Practice (Licence: DC DEN1001078) | |
Enumeration Date | 2012-07-02 |
Last Update Date | 2022-08-24 |