| NPI | 1659575710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27628) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 4353) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2022-07-21 |