| NPI | 1063666907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25271) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 25271) |
| 1223D0001X Dentist, Dental Public Health (Licence: FL dn18510) | |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2021-06-17 |