NPI | 1629563119 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MO 2018018448) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2018018448) |
Enumeration Date | 2018-06-27 |
Last Update Date | 2018-06-27 |