NPI | 1386204451 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DRPM2042) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DRPM2042) |
Enumeration Date | 2019-06-19 |
Last Update Date | 2019-06-19 |