| NPI | 1023013232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 19421) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 19421) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2018-04-26 |