NPI | 1669632808 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX TX25171) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN18324) |
Enumeration Date | 2008-06-11 |
Last Update Date | 2012-01-05 |