NPI | 1952655375 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: AZ D008480) |
Additional Taxonomies | 122300000X Dentist (Licence: AZ D008480) |
Enumeration Date | 2012-11-07 |
Last Update Date | 2023-08-08 |