NPI | 1952776494 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 31523) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 31523) |
Enumeration Date | 2015-12-09 |
Last Update Date | 2024-04-19 |