| NPI | 1598812646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 7079) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 19475) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2021-03-01 |