NPI | 1811429020 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33867) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1223G0001X Dentist, General Practice (Licence: MO 2017021248) | |
Enumeration Date | 2017-03-28 |
Last Update Date | 2024-06-19 |