| NPI | 1336318658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 0022894) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 38846) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2018-04-20 |