NPI | 1316396203 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE60989074) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021937) |
Enumeration Date | 2016-06-10 |
Last Update Date | 2020-12-15 |