NPI | 1740563600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NC 11090) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413345) |
Enumeration Date | 2011-09-27 |
Last Update Date | 2019-07-01 |