NPI | 1649371949 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30985) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 11683) |
Enumeration Date | 2006-09-26 |
Last Update Date | 2016-12-20 |