| NPI | 1033320544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 26205) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PR 2064) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2012-02-16 |