NPI | 1811090178 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL 16590) |
Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000008295) |
1223G0001X Dentist, General Practice (Licence: GA DN013293) | |
Enumeration Date | 2006-09-05 |
Last Update Date | 2015-04-10 |