NPI | 1174534630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 22752) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 22752) |
Enumeration Date | 2006-08-10 |
Last Update Date | 2024-07-18 |