NPI | 1497062764 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1858544) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25971) |
Enumeration Date | 2010-09-08 |
Last Update Date | 2021-09-29 |