NPI | 1508212333 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: FL 1518) |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: FL DN23387) |
Enumeration Date | 2016-05-11 |
Last Update Date | 2020-03-24 |