NPI | 1548791049 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NY 062386-01) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS041597) |
Enumeration Date | 2017-03-26 |
Last Update Date | 2022-11-07 |