| NPI | 1003042649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: TX 28547) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 28547) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2014-02-03 |