NPI | 1154939411 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 35176) |
Additional Taxonomies | 122300000X Dentist (Licence: MO 2020012233) |
Enumeration Date | 2020-07-22 |
Last Update Date | 2025-08-27 |