| NPI | 1295961464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26176) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 6372-15) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2018-03-17 |