NPI | 1922674654 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MO 2022044122) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SD B1308) |
1223G0001X Dentist, General Practice (Licence: SD D1308) | |
1223G0001X Dentist, General Practice (Licence: IA DDS-09889) | |
Enumeration Date | 2021-06-02 |
Last Update Date | 2024-05-13 |