NPI | 1811391162 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MD 15942) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401414545) |
Enumeration Date | 2014-10-15 |
Last Update Date | 2023-07-19 |