NPI | 1508350687 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX 40419) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 11116) |
Enumeration Date | 2018-06-21 |
Last Update Date | 2024-06-28 |