NPI | 1508086026 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: PA DS027760L) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7726) |
1223G0001X Dentist, General Practice (Licence: TX 30898) | |
Enumeration Date | 2007-04-26 |
Last Update Date | 2023-03-27 |