| NPI | 1831750827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11784) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 35231) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2024-01-04 |