| NPI | 1699814608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22874) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM 16-2006) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2011-02-17 |