| NPI | 1477752939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23233) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 08683) |
| 122300000X Dentist (Licence: NE 6798) | |
| Enumeration Date | 2007-07-15 |
| Last Update Date | 2017-12-18 |