NPI | 1699180356 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN24016) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS040058) |
1223G0001X Dentist, General Practice (Licence: VA 0401414695) | |
Enumeration Date | 2014-06-20 |
Last Update Date | 2019-08-25 |