NPI | 1396099891 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: PA DS039385) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 61627) |
1223G0001X Dentist, General Practice (Licence: PA DS039385) | |
Enumeration Date | 2012-11-05 |
Last Update Date | 2023-03-20 |