| NPI | 1194960070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: UT 12125111-9923) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 57936) |
| 1223G0001X Dentist General Practice (Licence: TX 25363) | |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2023-01-02 |