NPI | 1518296482 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 36893) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: LA 6794) |
Enumeration Date | 2009-12-23 |
Last Update Date | 2023-03-21 |