NPI | 1881029668 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD5029) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 62641) |
1223G0001X Dentist, General Practice (Licence: CO DEN00202360) | |
Enumeration Date | 2013-09-11 |
Last Update Date | 2023-01-04 |