NPI | 1912388075 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 32863) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 11415) |
Enumeration Date | 2015-06-15 |
Last Update Date | 2023-01-15 |