NPI | 1376941880 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CO DEN00205359) |
Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TN DS0000008292) |
1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: MA DN1856798) | |
Enumeration Date | 2014-12-15 |
Last Update Date | 2023-01-06 |