NPI | 1730178310 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN 14158) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 043069) |
Enumeration Date | 2005-10-17 |
Last Update Date | 2010-06-03 |