| NPI | 1053577288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24688) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 60584) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2018-02-12 |