| NPI | 1134440217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 29590) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 6176) |
| Enumeration Date | 2010-06-12 |
| Last Update Date | 2014-07-18 |