| NPI | 1649434234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 24548) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS-037530) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2011-07-12 |