| NPI | 1043218183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PR 2438) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 34839) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2019-07-02 |