NPI | 1851554117 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 23810) |
Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: TX 23810) |
Enumeration Date | 2008-07-08 |
Last Update Date | 2015-09-18 |