| NPI | 1346262201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 16813) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 6896) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-11-09 |