NPI | 1821520487 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 102740) |
Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CA 102740) |
1223G0001X Dentist, General Practice (Licence: TX 102740) | |
124Q00000X Dental Hygienist (Licence: TX 11165) | |
Enumeration Date | 2017-03-31 |
Last Update Date | 2024-04-25 |