NPI | 1316444664 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 37966) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02767500) |
1223G0001X Dentist, General Practice (Licence: NY 060802) | |
Enumeration Date | 2018-04-11 |
Last Update Date | 2024-04-23 |