NPI | 1770992935 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: AZ D008901) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 31634) |
122300000X Dentist (Licence: TX 31634) | |
Enumeration Date | 2014-08-12 |
Last Update Date | 2016-09-21 |