| NPI | 1215190954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31836) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 6130111-9922) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2022-03-08 |