| NPI | 1417434820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 37994) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 37994) |
| 122300000X Dentist (Licence: SC 9242) | |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2022-01-14 |