NPI | 1669564019 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 9958) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 044610) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2021-12-17 |