NPI | 1790302982 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: ME DEN4818) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ME TBD) |
Enumeration Date | 2020-07-03 |
Last Update Date | 2020-07-28 |