| 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 |