NPI | 1265516975 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22289) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22289) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2024-02-01 |