| NPI | 1457723926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 35021) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 9256) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2021-09-27 |