| NPI | 1801975867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 20627) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS043814) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2023-08-25 |