| NPI | 1356726814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 34380) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 00202606) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2019-01-30 |