NPI | 1962506428 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401410771) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN 13012) |
Enumeration Date | 2006-09-12 |
Last Update Date | 2007-07-08 |