| NPI | 1003150384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 7046) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 28449) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2024-09-20 |