| NPI | 1093703431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31380) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 009605) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2022-07-21 |