NPI | 1720355431 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: ME DEN4241) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30-023264) |
Enumeration Date | 2011-11-23 |
Last Update Date | 2012-10-19 |