NPI | 1861060568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 13496) |
Additional Taxonomies | 122300000X Dentist (Licence: CT 13496) |
1223G0001X Dentist, General Practice (Licence: TN 11606) | |
122300000X Dentist (Licence: TN 11606) | |
Enumeration Date | 2021-06-17 |
Last Update Date | 2024-01-15 |