| NPI | 1679690317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9637) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 21397) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2017-10-16 |