| NPI | 1184604043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23145) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 5663-015) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2011-02-23 |