| NPI | 1124332887 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28945) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1855518) | 
| Enumeration Date | 2010-08-04 | 
| Last Update Date | 2024-03-19 |