| NPI | 1295710531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26347) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 26347) |
| 122300000X Dentist (Licence: CA 58171) | |
| 122300000X Dentist (Licence: WA de00011142) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2021-05-28 |