NPI | 1760977326 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: UT 11629594-9923) |
Additional Taxonomies | 122300000X Dentist (Licence: NV 7082) |
Enumeration Date | 2018-06-26 |
Last Update Date | 2023-05-02 |