NPI | 1497124556 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 36717) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 8545) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 8545) | |
Enumeration Date | 2015-09-18 |
Last Update Date | 2021-04-09 |