NPI | 1578935979 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MI 2901022394) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS040784) |
Enumeration Date | 2015-10-24 |
Last Update Date | 2022-10-05 |