NPI | 1801209044 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE60830347) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 058080) |
Enumeration Date | 2014-06-05 |
Last Update Date | 2019-12-19 |