NPI | 1588386908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX 41380) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1859611) |
Enumeration Date | 2022-09-13 |
Last Update Date | 2025-05-20 |