NPI | 1235771395 |
---|---|
Former Name | GABRIELA A PALACIOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 37945) |
Additional Taxonomies | 122300000X Dentist (Licence: PR 032r) |
Enumeration Date | 2019-10-10 |
Last Update Date | 2023-04-04 |