NPI | 1134400781 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28870) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901020516) |
Enumeration Date | 2011-09-08 |
Last Update Date | 2024-04-29 |