NPI | 1568699270 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MO 2011010552) |
Additional Taxonomies | 122300000X Dentist (Licence: KS 60786) |
1223G0001X Dentist, General Practice (Licence: NE 6843) | |
Enumeration Date | 2009-06-20 |
Last Update Date | 2018-04-27 |