| NPI | 1376854356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26179) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1855416) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2024-06-12 |