NPI | 1760793277 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TX TX29842) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 29842) |
122300000X Dentist (Licence: FL 18650) | |
1223P0700X Dentist, Prosthodontics (Licence: FL DN18650) | |
Enumeration Date | 2010-06-30 |
Last Update Date | 2018-12-10 |