NPI | 1831469543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: TX 27596) |
Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: TX 27596) |
Enumeration Date | 2012-01-11 |
Last Update Date | 2012-01-11 |