NPI | 1912777004 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 40198) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 40198) |
Enumeration Date | 2024-01-08 |
Last Update Date | 2024-01-08 |