NPI | 1831465293 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NC 10529) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 50056977) |
Enumeration Date | 2012-03-29 |
Last Update Date | 2022-01-26 |