| NPI | 1326275686 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 34933)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS037908)  | 
| Enumeration Date | 2009-06-14 | 
| Last Update Date | 2020-06-26 |