NPI | 1497031512 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 011264) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413786) |
Enumeration Date | 2011-11-03 |
Last Update Date | 2014-10-07 |