| NPI | 1770897233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9627) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25705) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2017-02-01 |