NPI | 1669836409 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE61080297) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.024980) |
Enumeration Date | 2016-04-07 |
Last Update Date | 2022-04-11 |