| NPI | 1033201397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TN DS9546) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401411537) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2019-02-22 |