NPI | 1801866793 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS036217) |
Additional Taxonomies | 122300000X Dentist (Licence: PA ds036217) |
Enumeration Date | 2006-01-24 |
Last Update Date | 2023-12-15 |