NPI | 1609226646 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: PA DS040894) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE61170271) |
122300000X Dentist (Licence: UT 12078826-9921) | |
Enumeration Date | 2016-06-21 |
Last Update Date | 2021-08-10 |