NPI | 1629449897 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MA DN1857751) |
Additional Taxonomies | 122300000X Dentist (Licence: WI 1001222) |
Enumeration Date | 2015-10-14 |
Last Update Date | 2018-03-17 |