NPI | 1346778495 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MD LL883) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401415713) |
Enumeration Date | 2017-06-01 |
Last Update Date | 2021-08-18 |