NPI | 1154412351 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO DEN.00203765) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 20203) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2019-02-11 |