| NPI | 1821479361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30954) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 30954) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2021-05-25 |