NPI | 1285159848 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 167559) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 17131) |
1223G0001X Dentist, General Practice (Licence: PA DS041421) | |
Enumeration Date | 2017-08-04 |
Last Update Date | 2021-02-26 |