| NPI | 1043539695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33523) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401414293) |
| 1223G0001X Dentist, General Practice (Licence: NY 054855) | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2017-10-03 |