| NPI | 1407297799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 34559) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9044) |
| 1223G0001X Dentist, General Practice (Licence: MO 2013018603) | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2023-06-08 |