NPI | 1841873262 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901601163) |
Additional Taxonomies | 122300000X Dentist (Licence: ME DEN4913) |
Enumeration Date | 2021-05-03 |
Last Update Date | 2023-03-02 |