NPI | 1134571904 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37307) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 100333) |
1223G0001X Dentist, General Practice (Licence: FL DTC71) | |
Enumeration Date | 2016-07-05 |
Last Update Date | 2024-05-29 |