NPI | 1760827125 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA DDS108657) |
Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00201937) |
122300000X Dentist (Licence: TX 37031) | |
Enumeration Date | 2013-04-29 |
Last Update Date | 2023-05-31 |