| NPI | 1629207717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9909) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 24647) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2010-04-29 |