NPI | 1306406772 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24825) |
Additional Taxonomies | 122300000X Dentist (Licence: NM DD5113) |
Enumeration Date | 2019-06-18 |
Last Update Date | 2020-11-24 |