NPI | 1548608516 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DENT.DE.60364933) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DENT.DE.60364933) |
Enumeration Date | 2013-06-11 |
Last Update Date | 2013-06-11 |