NPI | 1043642929 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 32520) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 32520) |
122300000X Dentist (Licence: SD D1025) | |
122300000X Dentist (Licence: NE 7109) | |
Enumeration Date | 2013-08-02 |
Last Update Date | 2021-07-28 |