| NPI | 1821118019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 29593) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 2190400) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2016-03-08 |