NPI | 1871696146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401411165) |
Additional Taxonomies | 122300000X Dentist (Licence: MD 14701) |
Enumeration Date | 2006-09-05 |
Last Update Date | 2022-08-11 |