| NPI | 1184053712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VT 016.0133927) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 32384) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2024-10-24 |