NPI | 1407181332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25421) |
Additional Taxonomies | 122300000X Dentist (Licence: WV 3891) |
122300000X Dentist (Licence: PA DS038088) | |
Enumeration Date | 2009-10-09 |
Last Update Date | 2010-12-08 |