NPI | 1558687293 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE61100291) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901020106) |
1223G0001X Dentist, General Practice (Licence: IL 019028228) | |
Enumeration Date | 2010-04-19 |
Last Update Date | 2021-03-11 |