NPI | 1275088866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30.025626) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025626) |
122300000X Dentist (Licence: KY 9849) | |
Enumeration Date | 2016-08-24 |
Last Update Date | 2023-02-02 |