| NPI | 1346594462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D008521) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 32343) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2023-08-30 |