NPI | 1730444035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11240) |
Additional Taxonomies | 122300000X Dentist (Licence: TN 9491) |
1223G0001X Dentist, General Practice (Licence: NC 1730444035) | |
Enumeration Date | 2012-07-12 |
Last Update Date | 2024-05-14 |