NPI | 1194960070 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 12125111-9923) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 57936) |
1223G0001X Dentist, General Practice (Licence: TX 25363) | |
Enumeration Date | 2008-12-08 |
Last Update Date | 2023-01-02 |