NPI | 1295007573 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 27230) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 27230) |
Enumeration Date | 2012-02-02 |
Last Update Date | 2018-08-06 |