NPI | 1700195021 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 09994) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25639) |
Enumeration Date | 2010-10-04 |
Last Update Date | 2020-12-29 |