NPI | 1326654591 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 17188) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 12056) |
Enumeration Date | 2020-09-22 |
Last Update Date | 2023-08-23 |