NPI | 1669757670 |
---|---|
Former Name | MALATHI SHIRLEY LEWIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: TX F-25446) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX F-25446) |
Enumeration Date | 2011-10-21 |
Last Update Date | 2011-10-21 |