NPI | 1811125867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 25077) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25077) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-06-29 |
Last Update Date | 2012-06-12 |