NPI | 1992154660 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 30700) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 30700) |
Enumeration Date | 2016-06-03 |
Last Update Date | 2021-06-03 |