| NPI | 1649262197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 14840) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 14840) |
| 1223D0001X Dentist, Dental Public Health (Licence: TX 14840) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2020-10-12 |