NPI | 1275062465 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO 00204176) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 33004) |
Enumeration Date | 2017-06-09 |
Last Update Date | 2019-10-29 |