NPI | 1376066530 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AZ D011612) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 11154) |
1223G0001X Dentist, General Practice (Licence: LA 6807) | |
Enumeration Date | 2017-07-19 |
Last Update Date | 2022-12-13 |