| NPI | 1558749721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 35012) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 21379) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2019-05-27 |