| NPI | 1265988059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 37859) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 37859) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2024-10-14 |