NPI | 1750951505 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171000000X Military Health Care Provider (Licence: AL 10042) |
Additional Taxonomies | 122300000X Dentist (Licence: AL D-0006918-C1) |
Enumeration Date | 2021-06-24 |
Last Update Date | 2023-08-21 |