NPI | 1699220285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN26644) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021907) |
1223G0001X Dentist, General Practice (Licence: MI 2901021907) | |
1223G0001X Dentist, General Practice (Licence: CO 00203903) | |
Enumeration Date | 2016-08-24 |
Last Update Date | 2022-05-03 |