NPI | 1417434820 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 37994) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 37994) |
122300000X Dentist (Licence: SC 9242) | |
Enumeration Date | 2018-07-27 |
Last Update Date | 2022-01-14 |