| NPI | 1538579495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30778) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ N0DI02580900) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2017-03-20 |