NPI | 1619255395 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15091) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038800) |
Enumeration Date | 2011-07-28 |
Last Update Date | 2018-06-13 |