| NPI | 1255627683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 27044) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 27044) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2023-12-12 |