NPI | 1275046484 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 33164) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 33164) |
Enumeration Date | 2017-11-09 |
Last Update Date | 2020-07-29 |