| NPI | 1093185696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 30590) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 30590) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2024-01-09 |