| NPI | 1023003183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0008X Dentist Oral and Maxillofacial Radiology (Licence: TX 17112) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 17112) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2021-11-15 |