NPI | 1801255203 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ D011293) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 32739) |
Enumeration Date | 2016-02-15 |
Last Update Date | 2023-03-30 |