NPI | 1750980025 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 36785) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN122941) |
122300000X Dentist (Licence: TX 36785) | |
Enumeration Date | 2020-10-19 |
Last Update Date | 2025-08-15 |