NPI | 1467697714 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23018) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 5349) |
Enumeration Date | 2008-12-15 |
Last Update Date | 2020-06-17 |