| NPI | 1780607655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 7736) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 0023683) |
| 122300000X Dentist (Licence: TX 23683) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-08-01 |