NPI | 1295114841 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401416835) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN21136) |
Enumeration Date | 2015-05-28 |
Last Update Date | 2022-04-12 |