| NPI | 1619206562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25564) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 62253) |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2024-10-31 |