| NPI | 1043306814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 14838) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN5121) |
| 1223G0001X Dentist, General Practice (Licence: DC DEN5121) | |
| 122300000X Dentist (Licence: VA 0401417896) | |
| 1223G0001X Dentist, General Practice (Licence: VA 0401417896) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-06-28 |