NPI | 1588943484 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: PA DS039072) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS039072) |
Enumeration Date | 2011-08-09 |
Last Update Date | 2017-03-13 |