NPI | 1346362035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX 16908) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 41613) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2019-10-01 |