NPI | 1578673315 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 19180) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 19180) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2021-06-10 |