| NPI | 1194965293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31732) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 31732) |
| 1223G0001X Dentist, General Practice (Licence: PA DS037736) | |
| 1223G0001X Dentist, General Practice (Licence: NJ 22D102401200) | |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2018-09-17 |