NPI | 1477988269 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX 29394) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 29394) |
Enumeration Date | 2013-09-11 |
Last Update Date | 2021-02-05 |