| NPI | 1629144704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5257) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN013250) |
| 1223G0001X Dentist, General Practice (Licence: TX 24220) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2019-08-19 |