| NPI | 1629484753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 16705) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 30217) |
| 1223G0001X Dentist, General Practice (Licence: LA 6524) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2019-07-15 |