| NPI | 1134502628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 4287) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 31132) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2019-09-30 |