NPI | 1972037331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 33819) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 33819) |
Enumeration Date | 2017-04-12 |
Last Update Date | 2023-09-25 |