| NPI | 1417221169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TX 28097) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 28097) |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2022-10-06 |