| NPI | 1144583329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 29914) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D-5022) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-12-06 |