NPI | 1255648606 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26075) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 59724) |
Enumeration Date | 2010-09-07 |
Last Update Date | 2018-04-23 |