NPI | 1720527898 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60658473) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE60658473) |
Enumeration Date | 2017-02-22 |
Last Update Date | 2021-04-16 |