| NPI | 1588893424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO MSDEN00000003) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 24712) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2022-02-10 |