NPI | 1386684421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN 14976) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 19575) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2007-07-08 |