NPI | 1891386074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 61069699) |
Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: WA 61069699) |
Enumeration Date | 2021-01-29 |
Last Update Date | 2021-01-29 |