NPI | 1942753975 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL 22060) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS040998) |
Enumeration Date | 2016-07-26 |
Last Update Date | 2019-07-22 |