NPI | 1912645383 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: KY 11080) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.026792) |
Enumeration Date | 2022-05-25 |
Last Update Date | 2024-03-11 |