NPI | 1518111467 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 22814) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN28702) |
Enumeration Date | 2008-11-05 |
Last Update Date | 2025-07-30 |