NPI | 1720279490 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 22306) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 22306) |
1223G0001X Dentist, General Practice (Licence: CO DEN-9505) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 22306) | |
Enumeration Date | 2007-08-07 |
Last Update Date | 2023-06-20 |