NPI | 1891074183 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN19497) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413257) |
Enumeration Date | 2011-08-04 |
Last Update Date | 2014-01-15 |