NPI | 1235446642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO 00202111) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 6234) |
1223G0001X Dentist, General Practice (Licence: CA 59639) | |
Enumeration Date | 2010-09-07 |
Last Update Date | 2013-12-30 |