NPI | 1679027205 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 39300) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS04812) |
122300000X Dentist (Licence: PA ds040812) | |
Enumeration Date | 2016-08-11 |
Last Update Date | 2023-04-05 |