NPI | 1215235056 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2013013592) |
Additional Taxonomies | 122300000X Dentist (Licence: MO 2013013592) |
Enumeration Date | 2011-03-02 |
Last Update Date | 2019-07-18 |