| NPI | 1659534857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 30647) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 6024) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2021-03-08 |