| NPI | 1780225284 |
|---|---|
| Former Name | AISLEN YVETTE MEDINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 37143) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX ETN709) |
| Enumeration Date | 2019-10-05 |
| Last Update Date | 2023-02-15 |