NPI | 1538646906 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401416152) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401416152) |
Enumeration Date | 2018-07-27 |
Last Update Date | 2022-08-29 |