NPI | 1366761389 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL FC DN 19528) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60156700) |
Enumeration Date | 2010-06-01 |
Last Update Date | 2013-09-27 |