NPI | 1902199011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2016007765) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 056452) |
Enumeration Date | 2011-05-23 |
Last Update Date | 2022-07-21 |