NPI | 1790184968 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: LA 7487) |
Additional Taxonomies | 122300000X Dentist (Licence: OR D10119) |
1223E0200X Dentist, Endodontics (Licence: OR D10119) | |
Enumeration Date | 2014-08-13 |
Last Update Date | 2023-08-16 |