| NPI | 1215272430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ D011286) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 28539) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2022-05-19 |