| NPI | 1265925721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 12489) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 34157) |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2023-01-17 |