NPI | 1194933390 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 29779) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8372) |
Enumeration Date | 2007-05-19 |
Last Update Date | 2022-06-07 |