| NPI | 1407945876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 28653) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D7681) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2025-08-15 |