| NPI | 1194776682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 9161) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 21467) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2013-07-23 |