NPI | 1497002158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11046) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D4451) |
Enumeration Date | 2012-08-12 |
Last Update Date | 2021-12-02 |