NPI | 1871591685 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 7206) |
Additional Taxonomies | 122300000X Dentist (Licence: WI 6830-15) |
1223G0001X Dentist, General Practice (Licence: WI 6830-25) | |
Enumeration Date | 2005-07-14 |
Last Update Date | 2021-05-12 |