| NPI | 1225258155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26260) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 8424) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2015-08-15 |