NPI | 1306275110 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: VA 0401413972) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MD 15327) |
1223P0700X Dentist, Prosthodontics (Licence: DC DEN1001257) | |
Enumeration Date | 2013-11-03 |
Last Update Date | 2013-11-03 |