| NPI | 1306194451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 29516) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1856099) |
| 1223G0001X Dentist, General Practice (Licence: IL 019.029181) | |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2022-01-17 |