NPI | 1528415049 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2016024011) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 61249) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2016024011) | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KS 61249) | |
Enumeration Date | 2016-05-16 |
Last Update Date | 2016-08-18 |