NPI | 1427409267 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD D1451) |
Additional Taxonomies | 122300000X Dentist (Licence: IA DDS-09299) |
122300000X Dentist (Licence: PA DS042635) | |
Enumeration Date | 2016-06-23 |
Last Update Date | 2024-06-30 |