| NPI | 1487103321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 34253) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 937913664) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2019-02-04 |