| NPI | 1285094714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 35753) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2017014938) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2021-03-09 |