NPI | 1861799884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24957) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 24957) |
Enumeration Date | 2011-02-28 |
Last Update Date | 2013-10-15 |