NPI | 1417193897 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 014709) |
Additional Taxonomies | 122300000X Dentist (Licence: GA dn614709) |
1223G0001X Dentist, General Practice (Licence: NY 054076) | |
Enumeration Date | 2009-01-06 |
Last Update Date | 2021-10-28 |