| NPI | 1700195021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 09994) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25639) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2020-12-29 |