| NPI | 1811209844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122554) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 35766) |
| 1223G0001X Dentist, General Practice (Licence: OH 30023287) | |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2022-01-28 |