NPI | 1417499864 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: MI 2901022102) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901022102) |
Enumeration Date | 2016-11-15 |
Last Update Date | 2016-11-15 |