| NPI | 1538456132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: TX 27127) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 27127) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2013-12-17 |