| NPI | 1780723601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX F-21641) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX F-21641) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2011-08-18 |