NPI | 1548517576 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN015773) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 056853) |
Enumeration Date | 2012-08-09 |
Last Update Date | 2019-01-07 |