NPI | 1396361887 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD5350) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN24965) |
Enumeration Date | 2020-06-19 |
Last Update Date | 2020-10-09 |