| NPI | 1609322775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8824) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 32364) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2022-07-21 |