| NPI | 1558506592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 26199) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN DS0000008936) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2019-08-23 |