NPI | 1447991146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401417799) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 38124) |
Enumeration Date | 2022-04-05 |
Last Update Date | 2023-01-05 |