NPI | 1255959920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS042787) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS042787) |
Enumeration Date | 2020-07-09 |
Last Update Date | 2024-10-01 |