NPI | 1164619318 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 19522) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 19522) |
Enumeration Date | 2007-10-02 |
Last Update Date | 2008-11-06 |