| NPI | 1316058431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24755) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 24755) |
| 1223G0001X Dentist, General Practice (Licence: GA DN013108) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-08-05 |