NPI | 1245718154 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX 34410) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 34410) |
Enumeration Date | 2018-08-02 |
Last Update Date | 2018-08-02 |