| NPI | 1184030926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33615) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 6114) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2020-11-04 |