NPI | 1053005504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 39434) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 39434) |
Enumeration Date | 2023-06-07 |
Last Update Date | 2023-07-12 |