NPI | 1629649355 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401417807) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN122399) |
Enumeration Date | 2021-07-04 |
Last Update Date | 2023-11-02 |