NPI | 1407121262 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CO 00203851) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS020463L) |
122300000X Dentist (Licence: TX 30890) | |
122300000X Dentist (Licence: NY 057685) | |
Enumeration Date | 2012-03-13 |
Last Update Date | 2022-07-21 |