| NPI | 1568777654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 33259) |
| Additional Taxonomies | 122300000X Dentist (Licence: AR 3787) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2024-04-12 |