NPI | 1811626641 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WV 4591) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401418006) |
Enumeration Date | 2022-06-07 |
Last Update Date | 2022-07-29 |