NPI | 1417130667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: MN D12589) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.025038) |
Enumeration Date | 2007-12-11 |
Last Update Date | 2009-09-14 |