| NPI | 1740586577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27385) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 010440) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2011-10-27 |