NPI | 1962963843 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 125Q00000X Oral Medicine (Licence: VA 0411000067) |
Additional Taxonomies | 122300000X Dentist (Licence: GA 44205228) |
Enumeration Date | 2019-03-25 |
Last Update Date | 2023-08-21 |